Enrollment in health plans on the individual marketplace is lagging nationwide. And in Tennessee, participation is down close to 18 percent compared to the same time last year.
On Wednesday, the Centers for Medicare and Medicaid Services released a final weekly update before the Saturday deadline. In Tennessee, 97,320 people had selected a plan compared to 118,125 at the same point in 2017.
Marketplace advocates are bracing for bad news with the final tally, following a year that was down 2 percent. Family physician Tom Phelps of Tullahoma helped people sign up for plans through the Affordable Care Act in the first few years. He says the insurance exchange no longer receives as much attention, even from volunteers like him.
"It's something that's there and pretty well established," Phelps says. "But there has been a huge drop off for whatever reason."
Phelps, along with many Obamacare supporters, accuses the Trump administration of sabotage. Last year, the enrollment period was cut by half. Healthcare.gov is offline each Sunday morning and this year the marketing budget was slashed by 90 percent.
For consumers in Tennessee, monthly premiums have gotten a bit less expensive. But they also have new, cheaper options, like so-called association plans that don't provide all the benefits required on the marketplace. And some people likely plan to drop coverage entirely since there will no longer be a penalty for going without.
"I'm going to have to say that the majority of my friends don't have insurance and don't plan to," says Stephanie Hill, who works in interior design in Nashville.
Hill says her premiums have risen from nearly free when the Marketplace launched to $500 a month in 2019.
"For me, paying out of pocket would probably, at this point in time, be about the same amount unless you have a big event," she says, adding that she decided to keep her policy because she hopes to have a baby in the next few years.